[0001] The present invention relates to a pharmaceutical composition, its preparation and
use. More specifically this invention relates to an anti-inflammatory ophthalmic composition
comprising as active principle an-arylacetic acid or a pharmaceutically acceptable
salt thereof and to the preparation and use of such compositions.
[0002] Steroidal anti-inflammatory agents are well known which are effective in controlling
inflammation in the eye. However the use of steroids may give rise to undesirable
side-effects such as the masking or enhancement of corneal infections or cause elevation
of intraocular pressure, so that for certain ophthalmic compositions some authorities
would prefer to employ a non-steroidal anti-inflammatory agent.
[0003] Whilst a large number of non-steroidal anti-inflammatory agents including arylacetic
acids and their salts are known to be effective in the treatment of inflammatory conditions
such as arthritis when administered systemically it has been found that such agents
in general have little or no effectiveness when applied topically to the eye, for
example, in the form of eye drops. In our experience there is no correlation between
known systemic anti-inflammatory activity and anti-inflammatory effectiveness in the
eye. It has therefore been impossible to predict whether a given non-steroidal anti-inflammatory
agent would be effective in the eye or not. In fact so far no arylacetic acid has
found clinical use for topical administration in the eye.
[0004] Clearly it is desirable to provide a composition which may be administered to the
eye to reduce inflammation and which does not depend for its effectiveness on the
presence of a steroid.
[0005] A class of non-steroidal anti-inflammatory arylacetic acids is disclosed in US Patent
No. 3752826 (see also British Patent No. 1195628). Whilst the pharmaceutical use of
the 5-benzoyl pyrrole alkanoic acids in the systemic treatment of rheumatoid arthritis
and analgesia was described, no suggestion of the desirability of ophthalmic application
was made.
[0006] The present invention provides an anti-inflammatory ophthalmic composition comprising
as active principle a compound of formula (I):

or a pharmaceutically acceptable salt thereof wherein R
1 is a chlorine atom or a methyl group, R
2 is a hydrogen atom or a methyl group and R
3 is a hydrogen atom or a methyl group. This adaption of such compositions for topical
administration to the eye is surprising.
[0007] The compounds of the formula (I) are described in
US Patent No.3752826 (McNeil) and are now known to be excellent pharmaceutical agents.
[0008] A preferred compound of the formula (I) is 5-(p-methylbenzoyl)-1-methylpyrrole-2-acetic
acid (where R
1 is methyl and R
2 and R
3 are both hydrogen) hereinafter known ans "tolmetin".
[0009] Most suitably the compound of the formula (I) is in the form of a salt suitable for
ocular administration.
[0010] The composition of this invention is preferably presented as a clear, sterile aqueous
solution with the active principle present as a water-soluble salt. Particularly apt
salts include the sodium or potassium salt of which the sodium salt is preferred.
[0011] From the foregoing it will be realised that highly favoured active principles for
use in the compositions of this invention are the sodium and potassium salts of tolmetin
and that the preferred principle is the sodium salt of tolmetin.
[0012] Most suitably the composition of this invention will contain from 0.1-10% of the
active principle as hereinbefore described, more favourably from 0.4-7% of said active
principle and preferably 0.5-5%, for example 1-2% or 2-5% of said active principle,
(% terms when used herein are expressed on a wt/wt basis). Surprisingly clear aqueous
solutions containing such levels of the active principle can be prepared and are stable
to sterilisation techniques so that it is possible to provide the compositions of
this invention in sterile form which is of great desirability.
[0013] In general compositions containing low levels of the active principle will require
the presence of tonicity adjusting agents to bring the tonicity of the solution within
the prescribed ranges. Most suitably the composition of this invention is rendered
substantially isotonic, that is to say in terms of sodium chloride equivalent from
0.4 to 1.8% and more suitably from 0.6 to 1.5%. An isotonic solution has a sodium
chloride equivalent of 0.9%. A discussion of isotonicity, sodium chloride equivalent
and a list of tonicity agents is given in Remingtons' Pharmaceutical Sciences, Fifteenth
Edition, p. 1405-1412.
[0014] Aptly the compositions of this invention will contain an antioxidant. Suitable antioxidants
for use in this invention include citrate salts, N-acetyl cysteine, sodium thiosulphate,
sodium metabisulphate and thiourea. A preferred antioxidant is trisodium citrate.
[0015] Suitably the antioxidant is present in an amount from 0.01 to 2.5%, preferably 0.05
to 2% and more preferably is 0.5 to 1.5% for example 1%.
[0016] Aptly the compositions of this invention will contain a metal ion sequestering agent.
Suitable metal ion sequestering agents for use in this invention include sodium citrate,
8-hydroxyquinoline and its salts and ethylenediamine tetraacetic acid and its salts
for example the disodium salt. A preferred metal ion sequestering agent is trisodium
citrate.
[0017] Suitably the sequestering agent is present in an amount from 0.001 to 2% and more
preferably is from 0.5 to 1.5%.
[0018] From the aforementioned it is clear that an antioxidant and a metal ion sequestering
agent may be used in combination. A preferred agent which possesses both properties
is trisodium citrate. The presence of for example sodium citrate-has been found to
reduce the tendency of the compositions to discolour on storage by oxidation which
may be catalysed by metal ions such as those of group IIa, Ib, IIb and IVb of the
periodic table and in particular copper, ferrous and ferric ions. Secondly the presence
of for example trisdium citrate as a sequestering agent has been found to prevent
the precipitation of insoluble tolmetin salts of the metal ions described above and
in particular with calcium ions which may leach from a glass bottle.
[0019] Optionally compositions of this invention may be buffered to a pH value of from 6.0
to 8.6. For solution at the higher value of pH for example 8.5 the preferred buffering
system is a mixture of sodium borate and boric acid. At the preferred values of 7.0
to 8.0 the preferred buffering agents are a mixture of the alkali metal salts of orthophosphoric
acid. However the addition of a buffering system to the composition may introduce
inadvertently deleterious metal ions as described above and thereby require more chelating
agent present.
[0020] Compositons of the present invention may be prepared advantageously without the presence
of a buffer to have a pH value of 6.0 to 8.6 and more preferably from 7.0 to 8.0 for
example 7.5.
[0021] Optionally the compositions of this invention will contain a stabilizer such as a
surface active agent for example polyoxyethylene sorbitan fatty acid esters (commonly
called polysorbate and often called Tween) or polyoxypropylene-polyoxyethylene diol
block copolymers (commonly called Poloxamer). A preferred stablilser is polyoxyethylene
sorbitan monooleate, Tween 80. The presence of a stabiliser is not preferred.
[0022] Normally the compositions of the invention will contain a preservative such as a
phenylmercuric salt of nitric, boric or acetic acid or a quaternary ammonium compound
such as benzalkonium chloride or chlorbutanol or thiomersal, the sodium salt of 0-carboxyphenyl
thioethyl mercury or phenylethanol or phenoxyethanol, including combinations of thiomersal
with phenylethanol or benzalkonium chloride-and combinations of phenylmercuric nitrate
with phenylethanol or phenoxyethanol.
[0023] Preferred preservatives include a combination of thiomersal with phenylethanol and
thiomersal with phenoxyethanol. A particularly preferred preservative is a combination
of from 0.1 to 1% phenylethanol with 0.001 to 0.025% thiomersal, a most preferred
combination is 0.5% phenylethanol and 0.01% thiomersal.
[0024] The particularly favoured form of the composition of the present invention comprises
from 0.5 to 5.0% of the sodium salt of tolmetin, from 0.05 to 2% of trisodium citrate,
0.1 to 1% phenylethanol, 0.001 to 0.025% thiomersal in aqueous solution at a pH value
of
7.0 to8.0.
[0025] The preferred form of the composition of the present invention comprises from 1 to
2% of the sodium salt of tolmetin, 1% of trisodium citrate, 0.5% phenylethanol, 0.01%
thiomersal in aqueous solution at a pH value of 7.5.
[0026] In a further particularly favoured form of the composition of the present invention
an aminoglycoside or salt thereof may be present as an antibacterial. Aminoglycosides
which may be used include neomycin, gentamycin, framycetin, polymixin B, tobramycin,
kanamycin, vancomycin, amikacin and their salts include sulphate and phosphate. Suitably
the aminoglycoside or its salt is present in an amount from 0.1 to 3.0%, more favourably
from 0.2 to 1% and preferably 0.5%
[0027] In a preferred form of the composition of the present invention. the antibacterial
agent is neomycin or one of its salts, particularly aptly neomycin sulphate.
[0028] However, in aqueous solution in the absence of a solubilising agent at a pH value
of below 8.5 and more found to form rapidly at a pH value of below 8 the neomycin
cation has been/ with the tolmetin anion an insoluble product. To prevent the insoluble
product being precipitated from solution, a solubilising agent is preferably added.
This agent contains for example an anion selected from phosphate, citrate, glycerophosphate,
sulphate, tartrate or borate.
[0029] in solubilising neomycin The orthophosphate anion is particularly effective/ when
present in the form of disodium hydrogen orthophosphate or dipotassium hydrogen orthophosphate.
Such salts as phosphate may be produced in situ by the addition of suitable amounts
of sodium or potassium phosphate and phosphoric acid. However it is preferred that
citrate salts are used to aid in the solubilisation of neomycin. The most preferred
citrate salt being trisodium citrate. The amount of solubilising anion used depends
upon the weight of neomycin present. In general a weight ratio of solubilising anion
to neomycin sulphate of 1:1 to 8:1, preferably 2:1 to 3:1 is used.
[0030] Alternatively, polyvinyl pyrrolidone may be used instead of the solubilising anion
to maintain the active principles in solution. The amount of polyvinyl pyrrolidone
present may be from 1 to 20%, particularly from 5 to 15%.
[0031] A further particularly favoured form of the composition of the present invention
comprises from 0.4 to 7% of the sodium salt of tolmetin, from 0.2 to 1% of neomycin
sulphate, 0.05 to 2% trisodium citrate, 0.1 to 1% phenyl ethanol, 0.001 to 0.025%
thiomersal in an aqueous-solution at a pH value of 7.0 to 8.0.
[0032] The preferred form of the composition of the present invention comprises 2 to 5%
of the sodium salt of tolmetin, 0.5% neomycin sulphate, 1 to 2% trisodium citrate,
0.5% phenyl ethanol. 0.01% thiomersal in an aqueous solution at a pH value of 7.5.
[0033] A further preferred form of the composition of the present invention comprises 2
to 5% of the sodium salt of tolmetin, 0.5% of neomycin sulphate, 10% polyvinyl pyrrolidone,
0.5% phenylethanol, 0.01% thiomersal in an aqueous solution at a pH value of 7.5.
[0034] A further favourable composition of the present invention will contain as preferred
antibacterial chloramphenicol in an amount from 0.1 to 3%. Compositions containing
chloramphenicol will normally also contain a solubilising agent for chloramphenicol.
Solubilising agents for cbloramphenicol include sodium borate, polyvinyl alcohol and
polyvinyl pyrrolidone. A preferred solubilising agent is polyvinyl pyrrolidone having
a number average molecular weight of 40,000. This polyvinyl pyrrolidone is known as
Plasdone C-30 (Registered trade mark of GAF Corp.). The amount of polyvinyl pyrrolidone
present may be from 1 to 20%, particularly from 5 to 15%.
[0035] A further particularly favoured form of the composition of the invention contains
from 4.0 to 7% of the sodium salt of tolmetin, from 0.1 to 3.0% chloramphenicol, 5
to 15% polyvinyl pyrrolidone, 0.05 to 2% trisodium citrate, 0.1 to 1.0% phenylethanol,
0.0025 to 0.025% thiomersal in an aqueous solution having a pH value of 7.5.
[0036] A further preferred form of the composition of the invention contains from 2 to 5%
of the sodium salt of tolmetin, 0.5% chloramphenicol, 10% polyvinyl pyrrolidone, 0.5
to 1.5% trisodium citrate, 0.5% phenylethanol, 0.01% thiomersal in an aqueous solution
having a pH of 7.5.
[0037] Generally the compositions of the present invention will be formulated for either
a single or multi- dose pack. In single dosage form a suitable dose of the composition
may be contained in a single capsule equipped to deliver drops of solution. In this
presentation each capsule will hold from 0.3 to 0.7 ml. and will have been e.g. sterilised/by
autoclaving. More usually the composition will be provided as a multi-dose pack such
as neutral glass eye drop bottle with a polypropylene screw cap containing from 5
to 15 ml., usually 6 to 10 ml., for example 7.5 ml. In manufacture sterile bottles
or capsules may be filled aseptically with a solution sterilised by filtration. Alternatively
the bottle or capsule may be filled, sealed and the bottle or capsule and its contents
sterilised by heat, for example by autoclaving.
The concentration of the active ingredient in the composition is so adjusted that
each drop delivers a suitable dose for example 0.2 to 5mg. of for example the sodium
salt of tolmetin. Generally a drop will contain from 20 to 50 microlitres of solution.
The indications for use include pre- and post-operative inflammations, uveitis and
conjunctivitis. Administration of the drops will range from hourly to 3 times a day.
At each application usually 1 to 2 drops will be given.
[0038] In a preferred embodiment the invention provides a clear sterile aqueous solution
comprising the sodium salt of tolmetin and neomycin sulphate or chloramphenicol, a
solubiliser, an antioxidant, a sequestering agent and a preservative combination in
a multi-dose container provided with a dropper adapted to provide 0.2 to 5mg., more
usually 1 to 2mg, of the sodium salt of tolmetin in 1 to 5 drops of 20 to 50 microlitres
and preferably in I to 2 drops of solution.
[0039] The invention also embraces a single sterile drop of the said composition in liquid
form comprising from 1 to 2mg of the sodium salt of tolmetin.
[0040] Such a dosage is clearly distinguished from a dosage formulated for systemic use,
which may typically comprise from 100 to 200mg of the sodium salt of tolmetin and
is not in sterile form.
[0041] In further preferred compositions of the present invention the active principle is
contained in an emulsion. Preferred emulsions are those which are of the water-in-oil
type, whereby the oil is the continuous phase and the aqueous phase is dispersed in
it.
[0042] Suitably the emulsion will contain from 1 to 10% of the active principle, more suitably
0.5 to 5% and preferably from 2 to 5%. The active principle is suitably tolmetin or
the sodium salt of tolmetin. Preferably the active principle is the sodium salt of
tolmetin.
[0043] Suitably the emulsion will contain a sequestering agent or antioxidant as hereinbefore
described. Particularly suitable sequestering agents or antioxidants are the salts
of citric acid. Preferably the sequestering agent or antioxidant is trisodium citrate.
Suitably the sequestering agent or antioxidant is present in an amount from 0.01 to
2.0%, more suitably 0.075 to 1.5% and preferably from 0.1 to 0.5%.
[0044] Normally any pharmacologically acceptable oil may be used in the emulsions of the
present invention. Suitably these oils include vegetable and mineral oils such as
castor oil, liquid paraffin, white soft paraffin including mixtures thereof. Suitably
the oil phase will contain a mixture of liquid paraffin and white soft paraffin and
preferably will contain a mixture of liquid paraffin, white soft paraffin and castor
oil. Suitably the oil phase is present in an amount from 40 to 65% and preferably
from 45 to 60%.
[0045] Conventionally the emulsion of the present invention will contain one or more emulsifying
agents. Suitable emulsifying agents include glyceryl monoisostearate, ceto stearyl
alcohol, hydrogenated castor oil and sorbitan sesquioleate and including mixtures
thereof. Preferred emulsifying agents are glyceryl monoisostearate and glyceryl monoisostearate
together with sorbitan sesquioleate and hydrogenated castor oil. Suitably the emulsifying
agent is present in an amount from 1 to 20%, more suitably from 2.5 to 10%.
[0046] Suitably the emulsions of the present invention will contain a preservative. Suitable
preservatives include chlorbutanol, chlorocresol, benzalkonium chloride, thiomersal,
phenylethanol, phenoxyethanol and mixtures thereof. A particularly preferred preservative
is phenylethanol. Suitably the preservative is present in an amount from 0.1 to 1%
and preferably is 0.5%.
[0047] A suitable form of the emulsion of this invention contains 0.5 to 5% of the sodium
salt of tolmetin, 0.1 to 0.5% of trisodium citrate, 0.5% phenylethanol, 5.0% glyceryl
monoisostearate, 27.5% of liquid paraffin, 20.0% of white soft paraffin, 10.0% of
hydrogenated castor oil and 34.9% of water.
[0048] A preferred form of the emulsion of this invention contains 2 to 5% of the sodium
salt of tolmetin, 0.1 to 0.5% of trisodium citrate, 0.5% of phenylethanol, 3.0% of
glyceryl monoisostearate, 26.5% of liquid paraffin, 20.0% of white soft paraffin,
10% of hydrogenated castor oil, 3% of sorbitan sesquioleate and 34.9% water.
[0049] A further preferred form of the composition is as a sterile ophthalmic ointment.
Suitably the active principle is present as a compound of formula (I) or a pharmaceutically
acceptable salt. Particularly suitable compounds are tolmetin or the sodium salt of
tolmetin in either their anhydrous or hydrated forms. Particularly preferred is the
anhydrous form of the sodium salt of tolmetin. When in this form the compound may
be sterilised by gamma irradiation without discolouration. Suitably the active principle
is present in an amount from 0.1 to 10% and preferably from 0.5 to 6%.
[0050] Ointment bases suitable for this invention include a mixture of white or yellow soft
paraffin and liquid paraffin or the Eye Ointment Basis, comprising wool fat (1 part),
liquid paraffin (1 part) and yellow soft paraffin (8 parts), described in the Pharmaceutical
Codex 1979 llth Edition p 349. Preferred ointment bases include a mixture of white
soft paraffin and liquid paraffin in a ratio of 1:0.80 to 1:1.
[0051] It is desirable that ophthalmic ointments are sterile, substantially free from foreign
particulate contamination and the particle size of the active ingredient is reduced
to impalpability. It is preferred to prepare and pack the ointment under aseptic conditions
by bringing together pre-sterilised ingredients under sterile conditions. The ointment
base may be sterilised by melting together the ingredients and filtering through an
0.22 micron filter. The sodium salt of tometin may be sterilised by dissolving the
salt in water, filtering through a 0.22 micron filter and freeze-drying the sterile
solution. The material may then be ground and micronised aseptically. It is preferred,
however, to micronise the anhydrous sodium salt of tolmetin and then sterilise this
solid by gamma irradiation at 2.5 Mrad.
[0052] For use in ointments of this invention it is preferred that the solid sodium salt
of tolmetin is micronised that is to say 99% of the particles are smaller than 20
microns in diameter, 90% of the particles are below 10 microns. The majority of particles
are in the range of 1 to 5 microns in diameter.
[0053] A short discussion on the desirable properties and preparation of sterile ophthalmic
ointments is given in Remington's Pharmaceutical Sciences, Fifteenth Edition p. 1503-4.
[0054] The particular favoured form of the composition of the present invention comprises
a sterile ointment containing from 0.5 to 6% of the anhydrous sodium salt of tolmetin
and a mixture of white soft paraffin/liquid paraffin in a ratio from 1:0.8 to 1:1.
[0055] The preferred form of the composition of this invention comprises from 1 to 2% of
the anhydrous sodium salt of tolmetin, 52.5% white soft paraffin and from 44.5 to
45.5% liquid paraffin.
[0056] In a further form of the present invention the ointment described hereinbefore may
suitably contain an antibacterial agent such as an aminoglycoside or salt thereof
or chloramphenicol in an amount from 0.1 to 3%.
[0057] A particularly favoured form of the composition of the present invention comprises
1 to 2% of the anydrous sodium salt of tolmetin, 0.5% neomycin sulphate, 52.25% white
soft paraffin and from 45.25% to 46.25% liquid paraffin.
[0058] Alternatively a second favoured form of the composition comprises 1 to2% of the anhydrous
sodium salt of tolmetin, 1.0% of chloramphenicol, 52.5% white soft paraffin and 44.5
to 45.5% liquid paraffin.
[0059] The present invention also envisages a method of treatment of the human or domestic
mammal eye which comprises delivering thereto an anti-inflammatory composition of
this invention.
[0060] In order to demonstrate the effectiveness of the anti-inflammatory compositions of
the present invention, tests were carried out by the method given in "A detailed assessment
procedure of anti-inflammatory effects of drugs on experimental immunogenic uveitis
in rabbits". J.J. Ashford, J.W. Lamble in Investigative Ophthalmology 1974 13 (6)
414-421.
[0061] The effect of 1, 2 and 5% solutions of the sodium salt of tolmetin compared to vehicle
treated eyes in rabbits with unilateral immune uveitis was measured using bolometry.
[0062] The rabbits were dosed with 50 microlitres of the drug or vehicle applied topically
to the lower conjunctival sac at zero, 2, 3, 6, 8 and 24 hours from the challenge.
Representative measurements of corneal temperature were taken at 6, 24, 48 and 72
hours from the challenge.

[0063] The table shows the mean percent reduction of a number of sodium salt of tolmetin
solutions treated versus vehicle treated groups of the mean corneal temperature for
various concentrations of sodium salt of tolmetin.
[0064] A study on the anti-inflammatory activity of the sodium salt of tolmetin versus a
saline control was carried out in patients subsequent to cataract extraction. Eight
patients received 50 microlitres of a 5% aqueous solution of the sodium salt of tolmetin
four times daily for a period of 36 days or until the remaining inflammatory changes
were minimal. Seven patients received a similar amount of saline four times a day.
Each patient also received 1% atropine topically once daily. Atropine causes pupil
dilation thereby facilitating fundus examination and reduces the risk of fibrous strands
adhering the iris to lens.
[0065] By scoring signs and symptoms of inflammation, a noticeable improvement in these
patients receiving the sodium salt of tolmetin was seen at day +8 post-operation,
a definite improvement was seen at day +15 and by day +22 the difference in the two
groups was statistically highly significant.
Example 1
Sodium salt of tolmetin formulations
[0066]

The solution was prepared by dissolving phenylmercuric nitrate in approximately 25ml.
of distilled water at room temperature with stirring. Trisodium citrate and boric
acid were added and the solution stirred until both had completely dissolved. Then
the sodium salt of tolmetin was dissolved in this solution. The pH of the solution
was raised to 8.5 by addition of a 5% solution of sodium borate and the volume of
the solution finally made up to 100ml. with distilled water.
[0067] This solution was sterilised by filtration through a 0.22 micron filter from Millipore
and packed in multi- dose sterile glass eye-dropper bottles.
[0068] Alternatively the solution may be placed in multi- dose glass eye-dropper bottles
and the bottles and solution sterilised by autoclaving at 116°C for 30 minutes.
Example -2
Sodium salt of tolmetin formulation
[0069] A formulation was prepared containing:

[0070] Trisodium citrate, boric acid and the sodium salt of tolmetin were sequentially dissolved
in 40ml. of distilled water, the pH of the solution was adjusted to 8.5 with a 5%
solution of sodium borate and the volume of the solution was made up to 100ml. with
distilled water. 10g. of a chelating resin, Chelex 100 Resin (of BioRad Laboratories,
Richmond,California) was added to this solution and the mixture stirred together for
30 minutes and the resin was then filtered off.
[0071] The phenylmercuric nitrate was dissolved in the filtrate. The pH and volume of the
filtrate were re-adjusted to 8.5 and 100ml.
[0072] The solution was then filled into the multi-dose eye-dropper bottles in a nitrogen
atmosphere and sterilised by autoclaving at 116
0C for 30 minutes.
Example 3
Sodium salt of tolmetin formulation
[0073] A formulation was prepared containing:

Distilled water to make volume up to 100ml.
[0074] The solution was prepared as in Examples 1 and 2. The solution was then filled into
unit-dose packs and sterilised by autoclaving at 116
0C for 30 minutes.
Example 4
Sodium salt of tolmetin - Chloramphenicol formulation
[0075] A formulation was prepared containing:

[0076] The solution was prepared by dissolving phenylmercuric nitrate in 40ml. of distilled
water with stirring. Then the trisodium citrate, boric acid, sodium borate, polyvinyl
alcohol and chloramphenicol were added and dissolved in solution. When all the aforementioned
ingredients had completely dissolved, the sodium salt of tolmetin was added to the
solution and dissolved with stirring. The pH of the resultant solution was then adjusted
to a pH of 7.4 with sodium hydroxide solution and the volume made up to 100ml. with
distilled water.
[0077] The resultant solution was sterilised by filtration through a 0.22 micron filter
and filled into sterile eye-dropper glass bottles.
Example 5
Sodium salt of tolmetin - Chloramphenicol formulation
[0078] A formulation was prepared containing:

[0079] The solution was prepared, sterilised and packaged in the manner of Example 4.
Example 6
Sodium salt of tolmetin - Neomycin sulphate formulation
[0080] A formulation was prepared containing:

[0081] The solution was prepared by dissolving the trisodium citrate and phenylmercuric
nitrate in 50ml. of distilled water at room temperature, The neomycin sulphate was
added and dissolved in this solution. Polyvinyl pyrrolidone was added and the solution
stirred to ensure all the ingredients had dissolved. The sodium salt of tolmetin was
added and taken up into the solution.
[0082] The resultant solution was adjusted to a pH of 7.4 with sodium hydroxide and the
volume of the solution then made up to 100ml. with distilled water.
[0083] This solution was then sterilised and packaged in the manner of Example 4
Example 7
Sodium salt of tolmetin Ointment formulation
[0084]

[0085] The white soft paraffin and liquid paraffin were melted and mixed together to form
a homogeneous fluid. This fluid was sterilised whilst hot by passing through a 0.22
micron filter and collected in a sterile mixing vessel.
[0086] The sodium salt of tolmetin was dissolved in 40ml. of distilled water and filtered
through a 0.22 micron filter. The filtrate was freeze dried under sterile conditions
to give a sterile powder solid which has a particle size of less than 75 microns separated
by sieving. The requisite amount of this fine powder was intimately mixed with the
white soft paraffin/liquid paraffin mixture to give a sterile ophthalmically acceptable
ointment containing the sodium salt of tolmetin.
[0087] The ointment was then packed in conventional ointment tubes under sterile conditions.
Example 8
Sodium salt of tolmetin formulation
[0088]

[0089] This solution was then sterilised and packaged in the manner of Example 4.
Example 9
Sodium salt of tolmetin - neomycin formulation
[0090]

Sodium hydroxide solution to adjust the pH to 7.4 Distilled water to adjust the volume
to 100 ml.
[0091] This solution was then sterilised and packaged in the manner of Example 4.
Example 10
Sodium salt of tolmetin formulation
[0092] A formulation was prepared containing:

[0093] This solution was then sterilised and packaged in the manner of Example 4.
Example 11
Sodium salt of tolmetin ointment formulation
[0094]

[0095] The white soft paraffin and liquid paraffin were melted and mixed together to form
a homogenous fluid. This fluid was sterilised by passing through a 0.22 micron cellulose
ester bacterial filter and collected in a sterile mixing vessel.
[0096] The micronised anhydrous salt of tolmetin was sterilised by irradiation by gamma-rays
at 2.5 Mrads. This sterile powder was intimately mixed with the white soft paraffin/liquid
paraffin mixture under aseptic conditions to give a sterile ophthalmically acceptable
ointment containing the sodium salt of tolmetin.
[0097] The ointment was then packed in conventional ointment tubes under sterile conditions.
Example 12
Sodium salt of tolmetin/chloramphenicol ointment formulation,
[0098]

[0099] The ointment was prepared by the method described in Example 11, the micronised chloramphenicol
being sterilised and added in a similar manner to the sodium salt of tolmetin.
Examples 13 and 14
Sodium salt of tolmetin formulations.
[0100] Formulations were prepared containing:

[0101] A solution was prepared by dissolving phenylethanol and thiomersal in distilled water
(25ml). The trisodium citrate was then added and the solution stirred until all the
solid had dissolved. The sodium salt of tolmetin was then dissolved in this solution.
The pH value of the solution was adjusted to 7.5 by the addition of 5% citric acid
solution. The volume of the solution was finally raised to 100ml by addition of distilled
water.
[0102] This solution was sterilised by filtration through a 0.22 micron cellulose ester
bacterial filter and aseptically filled into multidose sterile glass eye-dropper bottles.
Examples 15 and 16
Sodium salt of tolmetin formulations
[0103] Formulations were prepared containing:

[0104] Solutions were prepared by dissolving the sodium citrate and sodium salt of tolmetin
in distilled water (25ml), adjusting the pH value to 7.5 with a 5% solution of citric
acid and finally adjusting the volume to 100ml with distilled water.
[0105] These solutions were then filled in to unit dose packs and sterilised by autoclaving
at 116
0C for 30 minutes.
Examples 17 and 18
Sodium salt of tolmetin - chloramphenicol formulation.
[0106] Formulations were prepared containing:

[0107] To prepare the solutions, the polyvinyl pyrrolidone, sodium citrate, thiomersal and
chloramphenicol were added to distilled water (60ml) and stirred until all the solid
had dissolved. The sodium salt of tolmetin was then added and the solution stirred
until the solid had dissolved. The pH value of the solution was adjusted to 7.5 by
addition of 5% sodium hydroxide solution. The volume of the solution was raised to
100ml by addition of distilled water.
[0108] These solutions were sterilised by filtration through a 0.22 micron cellulose ester
bacterial filter and aseptically filled into multidose sterile glass eye-dropper bottles.
Examples 19 and 20
Sodium salt of tolmetin - chloramphenicol formulations.
[0109] Formulations were prepared containing:

[0110] The solutions were prepared as described for Examples 17 and 18.
[0111] The solutions were filled into unit-dose packs and sterilised by autoclaving at 100°C
for 30 minutes.
Example 21, 22 and 23
Sodium salt of tolmetin water-in-oil emulsion.
[0112] Formulations of the sodium salt of tolmetin in the form of an emulsion (water-in-oil
type)
were prepared as follows:

[0113] The emulsions were prepared as follows. The sodium salt of tolmetin and trisodium
citrate were dissolved in the water and the resultant solution heated to 75-80°C.
The remaining components, constituting the oil phase, were mixed together and heated
to 80°C with stirring to produce a homogenous oily liquid. Whilst maintaining the
temperature and stirring the aqueous solution was added to the oily liquid and the
emulsion so formed allowed to cool with stirring. The product was produced as a stable
emulsion of the water-in-oil type.